机构:[1]Department of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China[2]Department of Thoracic Surgery, GuangdongEsophageal Cancer Institute, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative InnovationCenter of Cancer Medicine, Guangzhou 510060, China[3]Department of Thoracic Surgery, Affiliated Hospital of Qingdao University, Qingdao266001, China[4]Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China[5]Department of Endocrinology,Tianjin Medical University General Hospital, Tianjin 300052, China[6]Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu 610041,China外科中心胸外科中心四川省肿瘤医院胸外科[7]Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China[8]Department of Thoracic Surgery, FirstAffiliated Hospital of Anhui Medical University, Hefei 230022, China[9]Department of Thoracic Surgery, Affiliated Cancer Hospital of ZhengzhouUniversity, Zhengzhou 450008, China[10]Department of Thoracic Surgery, Beijing Cancer Hospital, Beijing 100142, China[11]Department ofCardiothoracic Surgery, Changhai Hospital, Shanghai 200433, China[12]Department of Thoracic Surgery, Liaoning Cancer Hospital, Shenyang110042, China[13]Department of Thoracic Surgery, First Affiliated Hospital of Jilin University, Changchun 130021, China[14]Department of ThoracicSurgery, West China Hospital, Sichuan University, Chengdu 610041, China四川大学华西医院[15]Department of Esophageal Cancer, Tianjin Cancer Hospital, Tianjin300060, China[16]Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China浙江省肿瘤医院[17]Department of Thoracic Surgery, JiangxiPeople’s Hospital, Nanchang 330006, China[18]Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai200030, China
Background: It is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG. Methods: The Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, patients were followed and their survival status were analyzed. Results: There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05). There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5- and 10-year overall survival (OS) rates were both higher in MG group (93% vs. 88%; 83% vs. 81%, P=0.034) respectively. The survival rate was significantly higher in patients with MG when the Masaoka staging was 3/4 (P=0.003). Among patients with advanced stage thymoma (stage 3, 4a, 4b), the constituent ratios of 3, 4a, 4b were similar between MG and non-MG group. Histologically, however, there were significantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000). Univariate analyses for all patients showed that MG, WHO classification, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were significant factors, and multivariate analysis showed WHO classification, Masaoka stage, and resectability were strong independent prognostic indicators. Conclusions: Although MG is not an independent prognostic factor, the survival of patients with thymoma was superior when MG was present, especially in late Masaoka stage patients. Possible reasons included early diagnosis of the tumor, better histologic types, an overall higher R0 resection and less recurrence.
Wang Fangrui,Pang Liewen,Fu Jianhua,et al.Postoperative survival for patients with thymoma complicating myasthenia gravis-preliminary retrospective results of the ChART database[J].JOURNAL OF THORACIC DISEASE.2016,8(4):711-717.doi:10.21037/jtd.2016.02.07.
APA:
Wang, Fangrui,Pang, Liewen,Fu, Jianhua,Shen, Yi,Wei, Yucheng...&Fang, Wentao.(2016).Postoperative survival for patients with thymoma complicating myasthenia gravis-preliminary retrospective results of the ChART database.JOURNAL OF THORACIC DISEASE,8,(4)
MLA:
Wang, Fangrui,et al."Postoperative survival for patients with thymoma complicating myasthenia gravis-preliminary retrospective results of the ChART database".JOURNAL OF THORACIC DISEASE 8..4(2016):711-717